Tuesday, August 31, 2010

Roth IRA Show Me The Money Home Care Path

The most important thing to ask an advisor when contributing to a Roth IRA (Individual Retirement Account) is when can I get my money. How can I get my money from a Roth IRA if I would need it. You want to understand the defined avenues for withdrawing money while avoiding excessive penalties and taxes.

Individual's who have made direct contributions (not a conversion from a traditonal IRA) can take money out tax free and penalty free if the money has been in the account for at least five years and you are fifty nine and a half years of age.

You can withdraw direct contributions at any time for any reason without taxes or penalties. If you contributed three thousand dollars to your Roth IRA over the years, you can withdraw three thousand dollars without taxes or consequesnces. So you can access your initial contribution. Taxes or penalties would apply only to the withdrawal of earnings beyond the three thousand dollars contributed.

The five year holding period for direct contributions actually starts the first day of the tax year for which you made your first deposit to the Roth IRA account. So if you made your first Roth IRA contribution on April 15, 2006 for the 2005 year, the five years would be January 2010. The money has not actually been in the account for five years and you have met the five year holding rule.

The Internal Revenue Service distributes (available online) IRS Publication 590 which explains the Roth IRA rules in detail. When you give someone your money, understand how you will get it back.

Monday, August 30, 2010

Medicare and Smoking

Years ago smoking cigarettes was an accepted past time in the United States. Smoking cigarettes was portrayed as a pleasurable experience. Money spent on tobacco products by consumers helped fuel the economy. Medical providers and the Centers for Disease Control began to collect documented reports of the disease producing effects of smoking cigarettes. Today health organizations in the United States define the smoking of cigarettes as a serious health hazard. Cigarettes have adverse health effects on the smoker and those near by due to second hand smoke being inhaled.

Medicare has expanded the federal role in reducing smokers of cigarettes in the United States. Medicare already covers drugs used to help smokers quit, and counseling for those who have a documented illness related to smoking cigarettes. Starting immediately Medicare has authorized coverage for up to eight counseling sessions per year for persons who simply have the desire to quit smoking cigarettes.

Collected data demonstrates seniors can respond to smoking cessation counseling even if they have been smoking for more than 40 years. The message clearly is it is never to late to quit smoking cigarettes and reduce your risk to complications from smoke related illness.

Medicare's medical officers see this as a cost saving strategy. Investing money in counseling to reduce the number of individuals lighting up cigarettes, will certainly help offset the billions the Medicare program spends on treating smoke related illnesses. The Medicare dollars collected by participating providers can be spent in local communities fueling the economy.

Sunday, August 29, 2010

Preventing Fraud Home Care Path

Home Care Path www.homecarepath.com staff are consistently monitoring avenues of fraud to help prevent an occurence in the seniors home. Some common avenues of fraud include:
- door to door home improvement sales visitors most often seen following a storm
- phone calls where the caller knows the seniors name, but the senior is unaware of who is calling examples include marketing, or donation requests
- mailings identifying the senior as a winner or promising a gift
- door to door magazine sales, young children passing through town
- visitors claiming to be disabled asking for cash, example visitor is claiming to be deaf and asking for money for college
- any phone calls requesting bank account numbers or social security number
- internet emails requesting personal information to correct a problem for the senior
- person attempting to sell a vehicle to a senior who has no valid drivers license
- visitor selling gap health insurance policy to a senior who is dual eligible, having both Medicare and Medicaid which would pay for needs beyond the Medicare benefit limit
- emails that offer to save money by buying in bulk
- visitors asking for advance payment for next seasons snow removal
- emails offering inexpensive cruise ship trips for payment today
- mailings for auto club member ships for seniors with no valid drivers license

Home Care Path staff encourage the entire community to keep a watchful eye out for scammers working near by. Communication is the key to fraud prevention.

Friday, August 27, 2010

Medicare Intermediaries Home Care Path

An Intermediary is an organization that has entered into an agreement with HCFA the Health Care Finance Administration to process Medicare claims. The money flows from the U.S. Government (Health Care Finance Administration) to the intermediary, down to the provider when a claim is submitted. The intermediary contracts with Medicare certified providers to process the claims under the authority granted by the Health Care Finance Administration (HCFA).

Intermediaries make payments to the Medicare certified providers they have contracted with. Providers can include hospitals, nursing homes (SNF skilled nursing facilities), home health agencies (HHA), and end stage renal disease facilities (ESRD). The amount of payment to any provider is restricted to a resonable cost of the covered services and items.

Intermediaries are mandated to assist in the application of safeguards against unnecessary use of covered services. Covered services and equipment must be deemed medically necessary. Intermediaries must assist the Medicare certified provider to establish and maintain the required fiscal data. Intermediaries serve as a center for communicating with Medicare certified providers. Intermediaries conduct systematic audits of provider records. Intermediaries over see the beneficiary appeal process. Intermediaries can assist providers in the process for becoming Medicare certified.

Certified Medicare providers have agreed in the contract with the intermediary not to charge the patient for items covered by the health insurance program other than allowable charges, deductibles, and coinsurance amounts. Home Care Path www.homecarepath.com staff assist seniors with organizing important papers. If Medicare is the pay source the provider cannot then charge the patient to collect more money than the Medicare intermediary has agreed to pay. This protects the patient from excessive charges.

Thursday, August 26, 2010

The Feil Method Home Care Path

The Feil Method is a validating technique used to improve communication with individuals diagnosed with dementia. The Feil method is now used in parts of Europe. Health Care Facilities (hospitals, nursing homes) in the U.S. are beginning to adapt The Feil Method as a model of practice used to communicate with seniors diagnosed with Alzheimer's disease.

Federal data indicates approximately 5 million persons in the United States are living with Alzheimer's disease and dementia like symptoms. Individual's living with Alzheimer's disease and memory loss communicate and behave in different ways. Staff in large health care facilities have been taught to immediately correct the patient, and to treat all persons the same. Administrator's have been taught to direct staff of hospital and nursing homes to serve the consumers in a cohesive, consistent manner. The Quality Improvement Department applauds adherence to a process regardless of the staff person serving the senior.

The Feil Method provides a technique that could be used consistently with all seniors with a memory loss diagnosis. The Feil Method teaches staff to become more verbally and socially engaged with the senior having memory loss. Hospital and nursing home medical staff have shown concern with the extra staff time needed for serving consumers with memory difficulty. Properly serving seniors with memory loss takes extra direct patient care staff and more of the staffs time.

The Feil Method is designed to help direct patient care staff better understand where the person with memory loss is coming from in all aspects of their health- physically, emotionally, and socially. Staff would reduce the frequency of treating behaviors with medication only. With The Feil Method direct patient care staff do not try to fix or correct a confused person. The behavior is seen as an attempt to communicate a need. Staff are challenged to engage the confused person in non-confrontational questions to determine the emotion or need being expressed. Find out what the confused person actually means to communicate to the people around them.

Attempts at greater communication by staff can improve the bond of trust. This improves the quality of care. Everyone wants to be cared for by someone they trust. The senior with memory loss may use less medication. The direct patient care staff will invest more time per confused patient. Staff tend to feel better when they can sense some progress helping improve the seniors quality of life. This can enhance staff morale.

Wednesday, August 25, 2010

Energy Workers Home Care Path

Energy workers see the mind, human body, and spirit as integrated and inseperable. At the center of energy work is the perception that you require internal balance-harmony, and external balance with your external environments. Energy workers shift the seniors focus from illness to wellness. The change is from within.

Energy workers begin by teaching the senior the things they focus on will expand. Investing thought in healthfulness will cause the senior to gravitate to more activites of wellness. The constant auto suggestion is "what I am doing to improve my own health". This is more beneficial then thinking my health is entirely in the hands of a disease the medical system has named. Seniors are taught to recognize subtle changes that indicate a gradual progression toward better health. The senior begins to feel a sense of control.

Energy workers provide the senior with sound preliminary steps to participating in various techniques for approaching perceived problems. The participation emphasis incorporates the idea of eternity. The use of eternity is a thought paradigm shift strategy. From the vantage point of an eternal role in existence, participation can be seen as a way to have fun. The senior sees the participation as a new way to see themselves playing out a temporary part in an episode of life. The energey worker is teaching the senior to emphasize consistent participation and fun over competition and winning. The senior begins to recognize the ability to take some time, go at their own speed, and better understand why they are doing things. This removes a level of stress from the equation.

Energy workers encourage the senior to question the meaning in the illness. The senior shifts from why is this disease attacking me, to what is this illness trying to tell me. The senior begins to understand the disease in a different way. The disease is not the problem. The disease is a name for the unpleasant attempts on the body's part to solve the problem. The unpleasant symptoms are being monitored by the medical system to give the senior a sense of the disease's residence in the physical body. Checks on blood pressure, blood sugar, sigmoidoscopy, are simply telling the medical provider the level of residence the undesired symptoms have in the physical body. Home Care Path www.homecarepath.com staff accompany seniors to visits.

With the help of the energy worker the senior begins to consider the illness as a message from within. The senior begins to explore the sense that illness goes deeper than germ theory. The illness is evaluated as having purpose and meaning in relation to the seniors inner states. Energy workers can consider an unmet need, or a repressed traumatic life event contributing to a thought tendency or unknown habit. The physical body symptom may be receiving energy from an inner state that wants the seniors attention. Change is from within.

Energy workers compliment the efforts of the medical system. Seniors going to an energy worker would be encouraged to continue to attend all medical provider visits. This is a holistic treatment approach. The senior may be visiting a medical doctor, energy worker, podiatrist, nutritionist, diabetic nurse educator, and an endocrinologist, all for a similar problem. Energy workers have a contribution to make to the wellness of seniors.

Tuesday, August 24, 2010

AUTUMN ALLERGIES Home Care Path

In autumn the male plants release pollen in to the air in order to reproduce. When the pollen and other allergy triggers are released, the bodies immune system sees them as foreign invaders. Ragweed is another autumn culprit. Allergic rhinitis more commonly known as hay fever is the bodies initial response to pollen and other substances.

Hay fever like symptoms are triggered when the immune system views harmless pollen or ragweed as dangerous substances that are attacking the body. The system over reacts by releasing chemicals in to the blood stream that inflame the lining of the nasal passages, sinuses, and eyelids which leads to sneezing. Fluid flows to push the pollen out, and the inner nose swells to prevent pollen entry. The immune system is responding in a way to protect the body from a substance that means it no harm.

The first allergy symptoms to show are itchy nose, mouth, eyes, problems with smell, runny nose, sneezing, tearing eye. Symptoms that can follow include nasal congestion, coughing, clogged ears, circles under eyes, puffiness around eyes, irritability, headache, memory problems, and slowed thinking. The constant flow of fluid from the nasal passages can irritate the skin below the nose.

To prevent autumn allergy symptoms begin by spending more time indoors. This reduces your bodies exposure to the cause of the allergy. Antihistamines which are available over the counter block the natural chemicals that the body produces that cause allergy symptoms. Home Care Path www.homecarepath.com staff assist seniors with shopping and errands. Loratadine, Claratin is an over the counter (no prescription needed) antihistamine. Over the counter decongestants are also used.

Monday, August 23, 2010

McKenzie Method Back Pain Home Care Path

Many therapists have become certified in the McKenzie Method which is helpful in treating chronic back pain. Certification in the McKenzie Method teaches providers how to treat back or neck pain in a safe, reliable way. When employing the McKenzie Method providers utilize a three step approach.

First the provider interviews the senior to get a thorough health history. Home Care Path www.homecarepath.com staff accompany seniors to provider visits. The provider then performs tests of movement to identify distinct patterns of pain responses. Spotting the areas of the body the pain has taken up residence. The provider is then able to create the most optimal treatment strategy for each specific place in the body the pain is recurring.

The provider then puts together a series of simple exercises for the senior to perform in the home setting. The exercises are based on the assessment process. The exercises are individualized and work on specific areas of the body where chronic pain has been located. The exercises are designed to reduce or abolish the pain sensation. The provider is promoting the body's potential to heal itself without medication, heat, cold, ultra sound, needles, surgery, or repetitive visits to therapists.

The final step is to plan out preventive strategies. The provider is teaching the senior how to treat their current pain problems. The provider reviews posturing, body positioning for life's daily tasks with the focus on avoiding more injury. Simple things like how you stoop to put on pants, to how you lift in to high cupboards. The provider gives the senior hands on knowledge to minimize the risk of recurrence. This includes quick things the senior can do if the pain does return.

A certified McKenzie provider will provide additonal hands on techniques until the senior can successfully manage the prescribed skills on their own. The process emphasizes education and active senior involvement in the management of treatment. This communicates self assist strategies the senior can perform in the home setting. This allows a sense of control over the chronic pain.

Sunday, August 22, 2010

The GE Signa HDxt 1.5T MR System Home Care Path

Health Care providers in rural settings are continually upgrading technology to better serve seniors. Health Care providers have become dependent upon information an MRI Magnetic Resonance Imaging Scanner can contribute to the medical diagnostic process. The GE Signa HDxt 1.5T MR system is a newer state of the art MRI unit.

The GE Signa HDxt 1.5T MR system will benefit the provider, the patient, and the over all health care system. This new MRI has many capabilities that will prevent seniors from having to travel to larger facilities for advanced diagnostic testing.

The GE Signa HD xt 1.5T MR system cuts down on the time needed to be spent in the MRI unit itself. Many routine exams can be performed faster. The GE Signa HDxt 1.5t MR produces sharper and higher resolution images. Providers find the images easier to read and result in more accurate prescribing of treatment and medication. The advanced software lessens the time radiology department staff need for each individual patient. The providers benefit from having reduced labor cost, and less need for repetitive diagnostic testing.

The patient is now required to spend less time in the MRI unit itself. This is great for patients that do not like to be in small places for very long. Having the GE Signa HDxt 1.5T MR in a nearby rural setting prevents the patient from having to travel to larger facilities for this advanced testing process. Less travel to big cities. Access to the GE Signa HDxt 1.5T MR means easier to interpret images for the radiology department. This can save the patient from exposure to higher radiation doses from other diagnostic tests. The patients benefit from having shorter visits and faster prescribing of treatment and medication.

The GE Signa HD xt 1.5T MR system in a rural setting can reduce fragmentation within the overall health care system. Less health care system dollars will be spent on repeat testing. The reduction of staff time per patient translates to the ability for more patients to be served. The health system is serving more people with the same labor cost. The sharper, higher resolution images can improve medical hospital treatment outcomes. Reducing the number of patients needing lengthy hospital stays can save the health care system money. The over all health care system benefits from being able to serve more patients with less money, and better patient outcomes with less hospital, nursing home expense.

Federal regulations will begin to more closely monitor repeat admissions to hospital and nursing homes. The GE Signa HDxt 1.5T MR system will give providers an edge to reduce hospital and nursing home readmissions.

Saturday, August 21, 2010

Celery Effect Blood Pressure? Home Care Path

Celery a European ammiaceous plant (apium graveolens), the leaf stalks of which are eaten raw and also cooked. Celery has been used as a folk (originated and used by large populations of common people) remedy to lower blood pressure in Asian cultures since 200BC. Chemical researchers have isolated and identified the chemical 3-n-butyl phdhalide responsible for the blood pressure lowering effect. Celery is a unique vegetable as the chemical 3-n-butyl phdhalide is found to be in rather high concentrations. The chemical 3-n-butyl phdhalide is also what gives celery its aroma. Researchers have speculated that celery lowers blood pressure by reducing blood concentrations of stress hormones that cause blood vessels to constrict. This suggests celery might be most effective in those who's blood pressure is linked to mental stress. Although celery is high in sodium (salt) compared to other vegetables one medium stalk still contains only a mere 35mg of sodium. So eating two stalks per day to try it, would only add 70mg, an insignificant amount of sodium to the diet.

Friday, August 20, 2010

Anabolic Androgenic Steroids Home Care Path

Since 1984 many organizations have publicly denounced or banned the use of anabolic steroids, including The American College of Sports Medicine, The American Medical Association, The National Collegiate Athletic Association, The International Olympic Committee, and The U.S. Power-Lifting Federation. Most States have also passed laws to ban or limit the selling of such products.

Anabolic androgenic steroids are synthetic formulations produced from testerone, the male hormone. Young adults have taken these agents to increase strength and body weight, to look good and improve their chances of winning in sports and athletic competitions.

Anabolic type effects include increased organ and skeletal muscle mass, increased calcium in bones, increased retention of total body nitrogen, increased hemoglobin concentration, and increased protein synthesis.

Androgen type effects include increased growth and development of the seminal vesicles and prostate gland, increased body and facial hair, increased production of oil from the sebaceous glands, deepening of the voice, increased sexual interest and desire, enhancement of abstract and spatial dimension thinking ability, and increased aggression.

In the past physicians prescribed anabolic steroids for an individual who was under weight. Many steroidal preperations were available and could be taken by the mouth. The medical community and sport organizations began to recognize athletes who did not follow physician recommendations and took dosages far in excess of the prescribed dosage. While the dosage of methandrostenolone dianabol was prescribed at 5mg per day some athletes were found to be taking 1000 to 1500mg per day over an extended period of time. This discovered abuse led to the withdrawl of this product from the market in 1982.

In 1991 all anabolic steroids were placed in the schedule C controlled substance category. Some States have placed the substances in schedule II category to further restrict the availability of these drugs for un intended use.

Thursday, August 19, 2010

Prescription Medication Home Care Path

The community network of hospitals, clinics, and nursing homes employs the medical model practise. The medical model uses medication, treatment, and education to improve the seniors health. The provider uses physical assessment, interview, and data review to determine a medical diagnosis and prescribes the medication, treatment , and education to improve health.

The purpose of medication is to modify existing physiological function. The most common mechanisms by which prescribed medication act to modify physiological function fall into these predictable categories. A medication can act to replace a function. Insulin helps remove sugar from the blood stream. A medication can enhance function. Bronchodilator expands the airways. A medication can impede the function. Cardiac medication decrease heart rate and blood pressure. A medication can destroy tissue. Chemotherapy and radioactive iodine. A medication can destroy an infection or infestation. Antibiotics destroy infection. This is the therapeutic purpose of prescribed medication.

The effectiveness of swallowing pills can depend on the prescribed medications bioavailability. Bioavailability means the rate at which the body can absorb the prescribed medication. If the medication is not being properly absorbed the senior will often complain the drug does not work anymore. The doctor can prescribe a similar medication with a higher bioavailability rate.

The pharmaceutical industry has shown seniors have physiological changes that require consideration when prescribing medication. Seniors normally have a decreased glomerular filtration rate, cardiac index, maximal breathing capacity, and hepatic blood flow. As the body ages the percentage of fat increases and the percentage of total body water decreases. These physiological changes mean that a greater portion of lipid soluble medication may accumulate in the body fat, a higher plasma concentration of water soluble medication may be noted, and metabolism by the liver and excretion by the kidney may be diminished. Prescribing providers have been taught to accomodate the changes associated with increased age.

Providers utilizing the medical model have a long history of successfully improving the health of individuals in the community. Home Care Path www.homecarepath.com staff provide nonmedical in home custodial care for seniors in South Central Wisconsin. Home Care Path staff assist seniors with follow through in the home setting.

Wednesday, August 18, 2010

Track Pension 401k Home Care Path

Old tax returns can be beneficial when tracking eligibility for a company pension 401k. Old tax returns can prove you worked at a company and did not receive a pension 401k distribution. Old tax returns can demonstrate you have worked enough years with the company to be vested. Being vested indicates you will receive a financial return.

Workers 20 years ago had to be on the job for 10 years or longer to be vested. Today workers are generally vested in private pensions after 5 years. With a 401k you are always entitled to your contributions, but might not be eligible to receive the employers match unless you have worked a certain number of years.

Search your residence for as much old paper work about your pension 401k you can get your hands on. Home Care Path www.homecarepath.com staff assist seniors with organizing important papers. Related documents will hold important clues as to where the pension 401k might be now. You are looking for the name of a financial firm that may be holding your money, or some benefits you are still due.

Many times the company will have merged with another company, changed its name, or gone completely out of business. You need to find out what happened to the old employer, and if a new company has taken over the pension 401k. You can contact the Employee Benefits Security Administration and request the help of an advisor. The Employee Benefits Security Administration is a federal agency specializing in resolving problems with retirement funds. The Employee Benefits Security Administration advisors can help in situations where companies have merged or the pension 401k plan has been abandoned. If your old employer is still operating at a company, just contact the human resources department.

If you locate an old pension 401k but do not have tax returns to demonstrate employment you can contact the Social Security Administration. Request form 7050 from the Social Security Administration. The Social Security Administration will charge you a fee for this document. Form 7050 will give you a detailed record of your earnings, including the name of your employer.

In retirement every penny counts. Keep in mind that a widowed spouse or other beneficiary may be entitled to some lost pension 401k money. Do Not let money that is owed to you and your family go unclaimed.

Tuesday, August 17, 2010

Upload Insurance Home Care Path

Upload insurance occurs at the point of sale. Upload insurance asks the consumer to spend additonal money on a policy that covers an ulikely loss. Upload insurance is for losses the consumer can easily cover out of pocket. The sellers of upload insurance make money.

A senior takes a package to the United States Post Office to be sent to a family member in another State. Home Care Path www.homecarepath.com staff assist seniors with packing and shipping items. The senior determines shipping cost would be about 2.60 for the package. The postal clerk then asks would you like shipping insurance to cover theft, loss, or damage to your package. The senior takes their vehicle in for new tires. A set of four tires will be about 312.00. The auto desk consultant then asks would you like insurance to cover an unexpected flat tire. The senior takes the prescription from the eye doctor to the eye glass frame retailer. The eye glass frame retailer in a white coat suggests you purchase additional insurance to cover your eye glasses and frames if they break. The senior goes in to an electronics retailer to purchase a lap top computer. The lap top is on special for 368.00. The electronics clerk strongly suggests the senior purchase an insurance that will extend the warranty coverage on the lap top computer. All examples of upload insurance.

Most upload policies require a time consuming process to submit a claim. The senior is shipping two metal badges purchased in a downtown souvenir store for 49 cents a piece to a nephew for his collection. The shipping insurance is about 1.30 for up to 50 dollars worth of coverage. Shipping insurance only covers the actual cost of the item and not the money spent for shipping of the objects. The senior notes more badges can be purchased from the same store for the same price at any time. So for about 1.00 the senior could get two more badges at any time. The badges can easily be replaced. The nephews residence has received many correspondence from this senior without any problems. The senior asks the postal clerk how a claim is handled. The clerk reports all shipping insurance claims are handled by the post master. The postal clerk explains that if the items are damaged, the receiver would talk with the post master that serves their area. The senior asks if this process can be completed on the phone. The clerk replies well no. The receiver would need to take the mailing receipt, the shipping insurance receipt, the items in their original shipping container, and paper work that documents the actual value of the items, in to the post master. So the senior would need to forward the receipts and information to the family of the nephew to file a claim. Depending on the availability of the post master at least one trip in to the post office would be required. The postal clerk explains to the senior that most likely the nephew will need an adult along because their are forms that need to be filled out during the post master visit portion of the claim process. The senior tells the postal clerk that even if he got the insurance and damage occurs it is highly unlikely the family of his nephew would ever follow through on the claim submission process. The postal clerk explains that staff are directed to offer shipping insurance to every customer mailing a package. The senior must make the decision as to the actual need for this additional insurance. In this scenario the senior did not purchase the extra shipping insurance.

Most upload insurance policies cover unlikely losses. Many upload insurance policies require a time consuming process to submit a claim. Most upload insurance sales pitches are delivered at the point of sale. The senior is in a retail check out line, other consumers are milling near by, the commotion can set one off balance. Both the retailer and the insurance provider benefit from the revenue collected with consumers purchasing upload policies. The retailer makes money selling you the additonal insurance. Before you purchase additional insurance at the point of sale you must know exactly how you would collect if a claim would need to be submitted.

Monday, August 16, 2010

Health Insurance Regs Home Care Path

The Wisconsin Insurance Commissioner will have increased responsibilites placed on them by President Barack Obama's health care legislation. The Wisconsin Insurance Commissioner will have clear legal authority granted through State legislators. The Office of The Insurance Commissioner will be required to systematically review insurance rates and demonstrate the capacity to enforce mandates.

Under the new federal mandates Wisconsin insurer's must offer insurance coverage to children under 19 and must allow adult children up to 26 to stay on the parent's policies. Wisconsin insurer's cannot charge co-payments for preventative services or impose a lifetime limit on benefits. Wisconsin insurer's are required to have a transparent process in place that allows the insured to appeal a denial of benefits. Insurer's cannot rescind coverage without strong evidence of fraud or intentional misrepresentation.

The Wisconsin Insurance Commissioner will have primary authority to insure mandates are being properly employed by State health insurance plan providers. Insurance plans will be challenged to collect and provide for review the documentation that demonstrates adherence to the new mandates. The State of Wisconsin's authority is granted by the United States federal government. Inability of the State of Wisconsin to properly fulfill its role in monitoring and enforcing the new mandates will result in a federal government take over of this process.

Historically, the office of the Wisconsin Insurance Commissioner will ask legislator's to put the federal mandates in to State law. This would expand legal authority and improve enforcement and over all follow through. Established procedures to review rates utilize increases as lead indicators to prioritize the process. The focus is on reviewing the rate increases.

The new mandates mean improved consumer protection specifically in the health insurance industry. The health mandates are consistently applied to health insurance plans. Beneficiaries can learn to expect to receive the benefit from these very important health insurance mandates.

Sunday, August 15, 2010

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Packing and Shipping for Seniors Home Care Path

One of the joys of senior living is sharing with family. Packing and shipping items to family can help the senior feel more connected. While out shopping in the Outlet Mall the senior purchases four Twilight movie themed shirts for the grandchildren. Home Care Path www.homecarepath.com staff determine the grandchildren all live in two seperate households approximately three blocks apart. The senior agrees shirts can be sent to one package and the receiver can distribute to the grandchildren of both houses. The senior would like the shirts to arrive safe and fast. The senior wants the grandchildren to be able to wear them with the summer season. Home Care Path staff and the senior find the items can be shipped by the United States Postal Service through priority mail. Home Care Path staff and the senior choose priority mail because the box is provided. Priority mailed items usually get to the persons home in 3-4 days. Home Care Path staff and the senior decide not to use the flat rate priority boxes because the items are shirts , lighter fabric. This can save some money. The senior and Home Care Path staff put together a hand written note to accompany the shirts. Home Care Path staff and the senior pack the shirts and the hand written note into the priority box provided by the Post Office. On each side of the box opening is a wax paper that lifts as the flap folds and the sealant closes the box securely. The senior and the Home Care Path staff write the return address and the shipping address on the box. The addresses are checked against the paper copies from the home to be sure they are written correctly. The Home Care Path staff and the senior apply some additional tape provided at the Post Office to each end. The box will be delivered just like letters would come to the families residence mail box. The postal clerk suggests mailing insurance which is about 1.30 for 50.00 worth of of coverage. The senior and the Home Care Path staff decide to insure the package for the 50.00. The total shipping cost is 7.34. The postal clerk provides the senior and the Home Care Path staff a mailing receipt and a mailing insurance receipt. The postal clerk instructs the the senior and the Home Care Path staff to hold on to the receipts until the merchandise has been delivered in a safe and timely manner. The senior and The Home Care Path staff call the family who will receive the package, requesting they contact the senior when the package arrives. The family calls the senior two days later to report the shirts arrived safe and sound and the grandchildren loved the surprise.

Friday, August 13, 2010

Funeral Planning Home Care Path

Many seniors plan their own funeral. This can mean paying in advance for funeral services and a burial plot. Cases continue to be reported to the State Of Wisconsin Funeral Board that regulates Funeral Directors. The report involves prepaid money being stolen by unethical business owners. Some Funeral Directors have advised planning ahead but keeping the money in a family bank account. The bank account should be set up so it is payable on death to the family member who will be in charge of arrangements. The senior needs to have a conversation with family members about their wishes. The family should be aware of the plans made and the bank account set up for payment. The funeral director provides a very important service to the community. The funeral directors ability to make money is dependent upon how much families spend. Families can find it easier to over spend in a greif stricken state. Try to remove the emotional portion by focusing on the family budget, wishes of the deceased, and religious, cultural traditions. Their is no monetary figure that best represents the current traditional or normal funeral. Most funeral directors will provide families with a price list in advance. Families can take the list home and allow extra time when evaluating realistic need.

Thursday, August 12, 2010

Medicare Home Care Path

Medicare continues to become more complex for the beneficiary. Medicare Part A is Hospital Insurance. Home Care Path www.homecarepath.com staff provide companionship with hospital stays. Medicare Part A has deductibles. A senior could have a 1 thousand dollar deductible for a hospital stay of 60 days. Medicare Part B is Medical Insurance , which covers Doctors services and supplies. Medicare Part B has a 155.00 annual deductible. Medicare Part B has a monthly premium of 110.50. Medicare Part B has no cap on out of pocket costs after Medicare pays 80 percent of the approved expenses. So once the 155.00 Part B deductible is met medicare pays 80 percent of the total approved expenses. The senior then owes the rest of the balance. This is the reason the insurance industry can successfully market the Medicare advantage plans, Medicare supplement plans, and the Medigap plans. These are various Medicare Part C insurance plans that help the senior pay for services beyond the Medicare coverage. Medicare Part D is drug coverage. Medicare Part C Advantage Plans can include the Medicare Part D component. Medicare Part D helps seniors pay for medications. Many plans have copays on the medications. Plans can also encourage seniors to take generic medication verses brand to reduce expense. Thankfully the State Of Wisconsin has regulated plans to insure some basic consistent level of service.

Wednesday, August 11, 2010

Coumadin & Cucumber Salad Home Care Path

Everyone has heard of the summer cucumber salad. Sliced fresh cucumbers, onions, vinegar, half n half, sits in the fridge, great over potatoes, with sweet corn. The difficulty begins with a big metal bowl to make the cucumber salad in. Retreiving the bowl from a high placed cupboard, the senior drops the metal bowl. The metal bowl bounces on the floor and rams the seniors lower left leg. The rim of the metal bowl has left its mark on the seniors leg. The complication to the bowl striking the leg is the seniors daily use of the drug Coumadin. Coumadin interferes with blood clotting. Coumadin can prolong bleeding in superficial breaks of the skin. The senior is told to sit down and put the feet up. Elevating the feet will reduce flow of blood to the fragile skin. The senior is given a towel with ice cubes wrapped inside and is to lightly apply for short period of time to the area of skin the bowl hit. The senior is told to expect a visible bruise like discoloration of the skin. The senior is well aware of the discoloration with any bumping of the skin. The senior reports bumping the hand on the corner of the table resulting in a visible bruise. The senior is given time to discuss how the discoloration of the skin can be brought up a lot, making them feel self conscious. this is a kind of change in ones body image. Allowing the senior to talk this through is a form of therapeutic listening. Higher up on the leg is four discolored spots from mosquito insect bites. We jokingly wonder if the mosquito can survive consuming the Coumadin in the seniors blood. Try the senior care web site www.homecarepath.com

Tuesday, August 10, 2010

The Advocacy Componenet of Senior Care Home Care Path

Advocacy has become an essential part of the senior care service for several important reasons. The Health Care System is experiencing an increased number of users. The Health Care System is in transition to prepare for the increased number of users. Fiscal contraints will demand more of the seniors using the Health Care System.

Today's senior care advocacy is built on the desire to protect the interests of the individuals who are unable to effectiviely participate in the Health Care System. The senior may lack the skill, knowledge, and energy to be effectively served by providers in the health care system. The Health Care System is adjusting its practice model to to better serve the increased number of users. The providers in The Health Care System are in the midst of change which is disruptive to medical staff as well as seniors. Conservative health business labor budgets can lessen the staff available to help when it is needed.

Medical staff continue to recommend seniors have a regular care giver who can attend all providers visits. Home Care Path www.homecarepath.com staff accompany seniors to provider visits to improve follow through in the home setting. Provider visits usually involve the senior telling the nurse all the current medications being taken. The nurse then checks the seniors vitals, blood pressure, pulse, respiration, body temperature, and level of pain. The senior is asked to state the chief complaint, what the problem is for today. The nurse will want to know exact facts regarding the problem. Like when the problem was first noticed, what seems to worsen the problem, etc. The interview process can take time, something that is in short supply with the changes the Health Care System is expereincing.

Many seniors will have multiple chronic symptoms being managed by daily medications. Seniors can have more symptoms, diagnosis, and take more medications with increased age. Seniors may experience some changes with memory. Often described as slow recall. So besides having more medications, symptoms, and diagnosis, the senior can experience memory loss, diffuculty with recall. The provider at the medical visit will want an accurate picture of what is taking place in the home to prescribe an effective treatment to help with the problem.

Seniors can expereince functional changes in the bodies ability to physically move. Slow or no ability to walk. Loss of vision can result in limited ability to read. Simply getting in to the providers room for the visit may take extra time and assistance. Extra time, and additonal staff to help, may be in short supply in todays Health Care System.

Home Care Path staff www.homecarepath.com are taught to participate in the advocacy component of senior care service. Staff take extra time in the home setting to collect adequate and accurate information. Staff collect adequate information to arrive at a written starement of the problem. The staff and the senior interpret all the collected information to formulate an accurate and acceptable explanation of the problem. Both the staff and the senior must come to an agreement on what the problem is. The senior and staff are now ready to present the problem to the medical provider at the Health Care System visit. During the medical visit the senior, the staff, the nurse, and the medical doctor agree on a recommended solution to the problem. The medical doctor prescribes a treatment for the problem. Home Care Path staff encourage the senior to comply with the prescribed treatment. The success of the visit depends on the senior participating in the prescribed treatment correctly. At home staff continue to encourage the senior to engage in the prevention activities. The Home Care Path staff provide ongoing support and direction to insure the senior benefits from the prescribed treatment.

From this description of the advocacy process one can see how the senior can benefit on all levels. The senior begins to sense purposeful results from the effort involved in the medical visits. The Health Care System provider staff become more comfortable in their ability to effectively serve the seniors ongoing needs. The home setting becomes mores consistent, stable, and can be a health giving dwelling.

Thursday, August 5, 2010

From Comparative Effectiveness to Patient Centered Research

PPACA is The Patient Protection and Affordability Act of 2010. PCORI is The Patient Centered Outcome Research Institute. Congress has disbanded the Federal Coordinating Council for (CER) Comparative Effectiveness Research. Federal authority has shifted from The Council For CER to PCORI The Patient Centered Outcome Research Institute. PCORI Board is appointed by the Comptroller General of The United States and supervised by The Government Accountability Office, which is currently an agency of the U.S. Congress. PCORI The Patient Centered Outcome Research Institute will operate as the federal funding authority for Patient Centered Research infrastructure. PCORI controls federal money in the form of contract grants. Large Health Organizations and Universities assemble systems that include data, research methods, staffing, training etc. to qualify for federal research money. PCORI The Patient Centered Outcome Research Institute will award contract grants to large Health Organizations, Universities, having the infrastructure to best perform the tasks required by the PCORI Mission. The Mission has shifted from comparative effectiveness to patient centered research. The focus with patient centered research calls for electronic linking of data sources. The observation of transparency with ongoing, fast, communication of information to the patient and medical providers. This will give patients and doctors more information so they can make the best medical decisions.

Sunday, August 1, 2010

Dimebon Home Care Path

Dimebon (Latrepirdine, Dimebolin) is an antihistamine drug. A 1980's Russian drug sold over the counter for hayfever symtpoms. Recently recognized by the pharmaceutical industry for its neuro protective properties, with a potential to combat Alzheimer's disease. Dimebon has been shown to inhibit brain cell death in pre clinical studies of Alzheimer's disease. The earliest series of studies were able to show the results necessary to facilitate the continuation of clinical research trials. In April of 2009 Pfizer and Medivation announced trials were unable to show desired benefit to participants with symptoms of Alzheimer's disease. This has been frustrating for prescribers who saw early trials of Dimebon demonstrate an ability to inhibit cellular death associated with neuro degenerative diseases. Currently The Dean Foundation www.dean.org is conducting a clinical research study to test the effects of an investigational medication (Dimebon) in patients with Alzheimer's disease . The study is to determine if Dimebon improves cognition, memory, daily functioning, caring for oneself, and behavior over a 12 month period. Participants will be required to have a regular care giver attend all 10 visits over the 12 month period. Home Care Path www.homecarepath.com staff attend provider visits with seniors to help improve follow through in the home setting. This Dean study is number 549, and JoAnn in Madison Wisconsin is the contact person.